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New Brain Imaging Technology Helps Reveal PTSD


Post-traumatic stress disorder, commonly called PTSD, is a major problem throughout the world. While it is commonly associated with veterans, brain imaging shows that it can affect anyone who has experienced a traumatic brain injury (TBI) or a traumatic event. It affects all ages, races, and genders, although some groups may be at higher risk than others.

PTSD is a Psychological trastorn in which a person experiences long-lasting stress or fear from a traumatic event that happened to them or that they witnessed. While it is natural for a person to experience trauma anxiety, this fear usually goes away after a short period. When it is not, it is considered chronic and then classified as a disorder.

One of the biggest problems with PTSD is that scientists have not been able to identify who will develop PTSD and who will not. However, new research may be the key to solving this problem. Scientists at the University of California, San Diego may have found brain biomarkers that can indicate PTSD after a TBI.

Study details

The principal investigator of the study was Dr. Murray B. Stein, MD, MPH, a practicing psychiatrist and professor of psychiatry at the University of California, San Diego (UCSD). Other project researchers included Dr. Esther Yuh, MD, Dr. Sonia Jain, MD, Ph.D., Dr. David O. Okonkwo, MD, Ph.D. and more. It was published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging in December 2020.


The study involved the use of brain imaging data and a clinical analysis known a Transforming research and clinical knowledge in TBI (TRACK-TBI). TRACK-TBI is a more extensive national study. This study aims to create a comprehensive database – a TBI Information Commons that the best scientists can access for TBI patients in the United States.

TRACK-TBI was started because of all the data collected from TBI cases in the last decades. There has not been a successful or lucrative clinical trial. The idea is that if there is a central database for scientists to obtain brain imaging data, it will allow for more convenient and effective collaborations, which should lead to useful results from scientific research.

Currently, the TRACK-TBI database contains data on more than 2,700 TBI patients, collected at 18 sites in the US It is open to scientists around the world to collect and use the information for studies. That is exactly what the UCSD researchers did.

The UCSD researchers obtained data from 421 patients in the TRACK-TBI database. The study requirements for inclusion were that patients must have been screened in the emergency department for a TBI, including brain imaging. These patients should also have been evaluated two weeks later, three months after, and six months after injury.

Three Tesla MRI machines

The researchers analyzed the volume of multiple brain sections using T2-weighted brain imaging in 3 teslas. This is important because most MRI machines use 1.5 tesla.

Although these new 3 Tesla MRI machines feature some challenges In the medical industry right now, using twice the power leads to higher resolution images. They are more accurate, so there is a significantly lower risk of the patient needing to be scanned again due to faulty images. However, the total time for brain imaging can be increased because the FDA limits the amount of heat that human tissue can accumulate in scanning sessions. This means that patients must wait longer for the tissue to cool down between scans.

For the UCSD study, 3 Tesla MRI scans allowed researchers to thoroughly analyze specific areas of the brain of TBI patients in greater detail than ever before. They were able to identify smaller lesions and anatomical structures, and other information that may not have been noticed with older 1.5 Tesla machines. The brain areas that were analyzed were:

  • The island
  • Hippocampus
  • Amygdala
  • Superior frontal cortex
  • Rostral anterior cincture
  • Caudal anterior cingulate
  • Lateral orbitofrontal cortex
  • Medial orbitofrontal cortex

They used volumetric analysis to analyze these areas. According to scientists, these areas can shrink in people suffering from TBI.

What the results mean

The researchers observed patients decrease in brain volumes at the time of your TBI or up to two weeks later. With the theory that this is the predictor for people who will have PTSD, they observed these patients at the 3-month mark. About 77% of these patients had PTSD at that time. The data were less close for determination around the 6-month mark. However, approximately 70% of the participants had PTSD at that time.

This is a study and to solidify the results, it must be replicated. However, the results of this study shed light on the possibility of a more specific preventive treatment for people who might have PTSD from TBI. It offers researchers and scientists a starting point. As Dr. Stein said, “it paves the way for future studies to look even more closely at how these brain regions can contribute to (or protect against) mental health problems like PTSD.”

How bad is PTSD?

To understand why this study is so important, it helps to know how serious PTSD is. As mentioned above, it is commonly associated with veterans and the PTSD statistics are scary. However, the statistics among non-veterans with PTSD are just as shocking.

First, you need to realize the number of traumatic events. According to the National PTSD Center, 60% of men and 50% of women will experience at least one traumatic event. Traumatic events include:

  • Domestic violence
  • Community violence
  • Serious car accident
  • Sexual abuse
  • Physical abuse
  • Child abuse
  • Some serious injury
  • The unexpected violent death of a loved one
  • A serious natural disaster
  • War and terrorism

With so many traumatic events What can happen, it is not surprising that almost 60% of the population experiences it at least once.

Not all people who experience a traumatic event will develop PTSD. According to statistics from the United States, an average of 8 percent of the population will develop PTSD at some point in their lives. However, the percentage is higher for women. Ten percent of women will develop it, while only 4% of men will develop it.

TBI Statistics

This article and the research it reviews specifically focus on TBI from traumatic events. Not all traumatic events result in traumatic brain injury; for example, the person may be a witness rather than a victim. However, studies have found that people with a TBI are more likely to develop PTSD than those who experienced a traumatic event without TBI.

TBI in the United States was expected to be one of the leading causes of death and disability. It is estimated that 2.87 million people in the US suffer a traumatic brain injury every year.

Of all the visits to the ER related to a traumatic brain injury, almost half of them they were due to falls. More than 80% of adults 65 and older suffered a traumatic brain injury due to a fall. For the age range 0-17 years, 49% of their TBIs were due to falls.

Car accidents were the second highest cause of TBI at 20%, while self-injury was the first leading cause of TBI-related deaths at 33%.

The effect of TBI on PTSD

While the event that causes a TBI is the culprit for PTSD, it goes a bit deeper than that. TBIs affect the brain at the cellular level, leading to a host of neurological disorders and diseases. PTSD is one of the most common.

As the study discussed in this article demonstrates, scientists link a shrunken brain to the development of PTSD (and other neurological problems). The amygdala is a popular focus area with the shrunken brain theory. It could be that TBIs damage brain cells, causing them to die in the process. This can cause the brain to shrink.

It’s almost like a catch-22. A shrunken brain can lead to the development of PTSD, but severe PTSD can also make the brain shrink.

It seems that a plausible short-term solution for PTSD would be to figure out how to reduce TBIs. That is a task that is easier said than done. It would take significant effort for this to happen.

Final thoughts on brain imaging, TBI, and PTSD

Science is continually evolving and this is good news for the discipline of neuroscience. There is a massive lack of understanding when it comes to neurological disorders like TBI and PTSD, so any breakthrough can make a huge difference. Researchers at the University of California, San Diego have made a significant contribution to the scientific community.

The hope is that this research will pave the way to preventive care for one of the worst neurological disorders facing humans. Perhaps people can also find a way to reduce brain injury in the first place. These two efforts combined could be the key to improving the mental health of the world on a significant scale.


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